|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$422.00 |
$422.00 |
$422.00 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$226.00 |
$226.00 |
$226.00 |
$21,790.11
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$571.50 |
$571.50 |
$571.50 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$885.50 |
$885.50 |
$885.50 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$8,300.00 |
$8,300.00 |
$8,300.00 |
$5,096.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$451.50 |
$451.50 |
$451.50 |
$1,777.39
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$166.50 |
$166.50 |
$166.50 |
$189.15
|
|
Alpha-fetoprotein amniotic
|
$42.50 |
$42.50 |
$42.50 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$69.50 |
$69.50 |
$69.50 |
$103.80
|
|
Alt/sgpt
|
$18.50 |
$18.50 |
$18.50 |
$47.40
|
|
Aluminum - quest
|
$38.00 |
$38.00 |
$38.00 |
$81.49
|
|
Alys cplx sp/pn npgt w/prgrm
|
$138.50 |
$138.50 |
$138.50 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$513.50 |
$513.50 |
$513.50 |
$179.70
|
|
Aminolevulinic acid delta
|
$84.00 |
$84.00 |
$84.00 |
$85.15
|
|
Amitriptyline (elavil) -sendout
|
$81.00 |
$81.00 |
$81.00 |
$84.56
|
|
Ammonia
|
$74.00 |
$74.00 |
$74.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$376.00 |
$376.00 |
$376.00 |
$923.50
|
|
Amniocentesis therapeutic
|
$414.00 |
$414.00 |
$414.00 |
$791.05
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$2,226.00 |
$2,226.00 |
$2,226.00 |
$3,735.51
|
|
Amphetamine confirm urine -sendout
|
$138.50 |
$138.50 |
$138.50 |
$93.61
|
|
Amphetamines 5 or more
|
$80.50 |
$80.50 |
$80.50 |
$90.48
|
|
Amp metatarsal w/toe single 28810
|
$2,757.00 |
$2,757.00 |
$2,757.00 |
$3,986.00
|
|
Amputate metacarpal bone 26910
|
$3,528.50 |
$3,528.50 |
$3,528.50 |
$3,839.54
|
|
Amputation toe metatarsophalangeal joint
|
$2,868.00 |
$2,868.00 |
$2,868.00 |
$3,839.54
|
|
Amylase
|
$46.00 |
$46.00 |
$46.00 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$180.00 |
$180.00 |
$180.00 |
$80.08
|
|
Anal pressure record
|
$787.50 |
$787.50 |
$787.50 |
$946.24
|
|
Anal/urinary muscle study
|
$798.50 |
$798.50 |
$798.50 |
$407.00
|
|
Anal/urinary muscle study
|
$798.50 |
$798.50 |
$798.50 |
$587.40
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$116.00 |
$116.00 |
$116.00 |
$335.85
|
|
Analysis gene f2 20210g>a variant
|
$364.50 |
$364.50 |
$364.50 |
$222.05
|
|
Analysis gene f5 leiden variant
|
$364.50 |
$364.50 |
$364.50 |
$237.60
|
|
Analysis nerve
|
$119.50 |
$119.50 |
$119.50 |
$262.40
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$37.00 |
$37.00 |
$37.00 |
$123.84
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$138.50 |
$138.50 |
$138.50 |
$375.00
|
|
Anca screen with reflex to titer -quest
|
$312.50 |
$312.50 |
$312.50 |
$99.00
|
|
An cholangiogram percutaneous compl
|
$1,404.50 |
$1,404.50 |
$1,404.50 |
$2,494.35
|
|
An fluoro guide for cvp
|
$407.00 |
$407.00 |
$407.00 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,640.00 |
$4,640.00 |
$4,640.00 |
$5,500.00
|
|
Angioplasty fem/pop unilat 37224
|
$5,429.50 |
$5,429.50 |
$5,429.50 |
$8,835.00
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$5,585.00 |
$5,585.00 |
$5,585.00 |
$10,173.90
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$5,433.00 |
$5,433.00 |
$5,433.00 |
$5,950.50
|
|
Angio tib/peroneal/init ves/unila 37228
|
$6,113.50 |
$6,113.50 |
$6,113.50 |
$10,513.36
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,640.00 |
$4,640.00 |
$4,640.00 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$6,605.50 |
$6,605.50 |
$6,605.50 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,640.00 |
$4,640.00 |
$4,640.00 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$6,605.50 |
$6,605.50 |
$6,605.50 |
$8,466.00
|
|
Ankle X-ray
|
$197.50 |
$197.50 |
$197.50 |
$352.80
|
|
Anl sp inf pmp w/mdreprg&fil
|
$279.50 |
$279.50 |
$279.50 |
$627.94
|
|
Anterior thoracic extension
|
$454.00 |
$454.00 |
$454.00 |
$496.80
|
|
Antibody elution rbc reference
|
$189.50 |
$189.50 |
$189.50 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$159.00 |
$159.00 |
$159.00 |
$131.28
|
|
Antibody htlv-i
|
$72.50 |
$72.50 |
$72.50 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$489.50 |
$489.50 |
$489.50 |
$219.30
|
|
Antibody id rbc panel
|
$209.00 |
$209.00 |
$209.00 |
$290.21
|
|
Antibody influenza virus
|
$91.50 |
$91.50 |
$91.50 |
$53.90
|
|
Antibody screen rbc
|
$83.00 |
$83.00 |
$83.00 |
$106.88
|
|
Antidepressant not specified
|
$151.00 |
$151.00 |
$151.00 |
$72.14
|
|
Antigen therapy services
|
$30.00 |
$30.00 |
$30.00 |
$73.84
|
|
Antigen therapy services
|
$43.00 |
$43.00 |
$43.00 |
$83.72
|
|
Antigen therapy services
|
$34.00 |
$34.00 |
$34.00 |
$70.07
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$324.50 |
$324.50 |
$324.50 |
$37.58
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$40.50 |
$40.50 |
$40.50 |
$42.00
|
|
Antinuclear antibodies
|
$102.50 |
$102.50 |
$102.50 |
$90.00
|
|
Antinuclear antibodies titer
|
$91.00 |
$91.00 |
$91.00 |
$79.86
|
|
Antiphosphatidylserine antibody
|
$83.00 |
$83.00 |
$83.00 |
$64.50
|
|
Antipsychotics nos 1-3
|
$157.00 |
$157.00 |
$157.00 |
$137.80
|
|
Antistreptolysin o titer
|
$47.00 |
$47.00 |
$47.00 |
$52.50
|
|
Antithrombin iii activity
|
$117.50 |
$117.50 |
$117.50 |
$114.00
|
|
Ant sgm img i&r speclr mic
|
$133.50 |
$133.50 |
$133.50 |
$286.00
|
|
Aphakia prosth service temp
|
$79.00 |
$79.00 |
$79.00 |
$81.12
|
|
Apheresis immunoads slctv
|
$3,144.50 |
$3,144.50 |
$3,144.50 |
$5,794.21
|
|
Apheresis plasma
|
$2,142.50 |
$2,142.50 |
$2,142.50 |
$3,188.50
|
|
Apheresis platelets
|
$2,567.50 |
$2,567.50 |
$2,567.50 |
$2,195.00
|
|
Apheresis rbc
|
$1,592.50 |
$1,592.50 |
$1,592.50 |
$3,290.80
|
|
Apl(pml-rara) quant - sendout
|
$477.50 |
$477.50 |
$477.50 |
$500.80
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,564.00 |
$1,564.00 |
$1,564.00 |
$2,112.66
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$490.50
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$3,215.50 |
$3,215.50 |
$3,215.50 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,250.50 |
$2,250.50 |
$2,250.50 |
$1,132.20
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$508.18
|
|
Appl hip spica cast1&1/2
|
$305.50 |
$305.50 |
$305.50 |
$501.28
|
|
Application clubfoot cast
|
$212.50 |
$212.50 |
$212.50 |
$303.00
|
|
Application finger splntstatic 29130
|
$190.00 |
$190.00 |
$190.00 |
$208.50
|
|
Application long leg splint 29505
|
$146.00 |
$146.00 |
$146.00 |
$338.25
|
|
Application lower leg splint 29515
|
$138.00 |
$138.00 |
$138.00 |
$334.20
|
|
Application multi layer compression below knee (both sides)
|
$148.50 |
$148.50 |
$148.50 |
$370.92
|
|
Application of cylinder cast 29365
|
$192.50 |
$192.50 |
$192.50 |
$431.08
|
|
Application of forearm cast 29075
|
$254.50 |
$254.50 |
$254.50 |
$356.50
|
|
Application of long arm cast 29065
|
$254.50 |
$254.50 |
$254.50 |
$395.45
|
|
Application of long leg cast
|
$185.50 |
$185.50 |
$185.50 |
$435.54
|
|
Application of long leg cast 29345
|
$171.00 |
$171.00 |
$171.00 |
$455.00
|
|
Application of paste boot 29580
|
$148.50 |
$148.50 |
$148.50 |
$336.00
|
|
Application short leg cast 29405
|
$247.50 |
$247.50 |
$247.50 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,564.00 |
$1,564.00 |
$1,564.00 |
$2,109.00
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,564.00 |
$1,564.00 |
$1,564.00 |
$2,123.50
|
|
Appl modality 1/> areas paraffin bath 97018
|
$40.00 |
$40.00 |
$40.00 |
$68.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$31.50 |
$31.50 |
$31.50 |
$76.80
|
|
Apply finger cast 29086
|
$156.00 |
$156.00 |
$156.00 |
$242.20
|
